Vitrectomy for diabetic macular edema: the role of poterior vitreou detachment and epimacular membrane

PURPOE: To evaluate the urgical efficacy of par plana vitrectomy on eye with diabetic macular edema in the preence or abence of a complete poterior vitreou detachment and with or without an epimacular membrane. METHOD: Par plana vitrectomy wa performed on 30 eye of 29 cae with diabetic macular edema. Viual acuity wa meaured, and retinal thickne wa determined by optical coherence tomography before and after vitrectomy. To evaluate the relationhip between the effect of vitrectomy and the preence or abence of poterior vitreou detachment and/or epimacular membrane, all eye were placed into one of four group: group A, eye with poterior vitreou detachment and epimacular membrane; B, eye with poterior vitreou detachment and without epimacular membrane; C, eye without poterior vitreou detachment and with epimacular membrane; and D, eye without poterior vitreou detachment and without epimacular membrane. The expreion of vacular endothelial growth factor and interleukin-6 wa invetigated immunohitochemically in epimacular membrane pecimen obtained from even eye with diffue diabetic macular edema. REULT: The potoperative mean viual acuity (0.653 ± 0.350: mean ± D logarithm of minimal angle of reolution [logMAR]) wa ignificantly better than the mean preoperative viual acuity (0.891 ± 0.319 logMAR; Wilcoxon igned-rank tet, P = .0007). The potoperative foveal thickne (264.5 ± 118.6 μm) wa ignificantly thinner than the preoperative foveal thickne (477.8 ± 147.7 μm; Wilcoxon igned-rank tet, P < .0001). There were no ignificant difference in the improvement of viual acuity and decreae of foveal thickne between the four group (Krukal-Walli tet, P = .13, P = .65, repectively). All of the epimacular membrane obtained at urgery expreed vacular endothelial growth factor and interleukin-6. CONCLUION: Thee reult demontrated that vitrectomy with removal of epimacular membrane i generally an effective procedure in reducing diabetic macular edema, and the outcome doe not depend on the preence abence of poterior vitreou detachment and epimacular membrane